Provider Demographics
NPI:1275793168
Name:GREATER METROPOLITAN ORTHOPAEDICS
Entity Type:Organization
Organization Name:GREATER METROPOLITAN ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SABLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-856-1682
Mailing Address - Street 1:11325 PEMBROOKE SQ
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4807
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-843-2946
Practice Address - Street 1:11325 PEMBROOKE SQUARE
Practice Address - Street 2:SUITE 115
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603
Practice Address - Country:US
Practice Address - Phone:301-719-1167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
145530100OtherDEPT OF LABOR
4695OtherCAREFIRST BCBS OF DC
0254450005OtherMEDICARE NSC
176608OtherMETRO MEDICARE
462LOtherMARYLAND MEDICARE
DG8302OtherRAILROAD MEDICARE
S176OtherCAREFIRST BCBS MARYLAND
I20600Medicare UPIN
176608OtherMETRO MEDICARE
S176OtherCAREFIRST BCBS MARYLAND
I60636Medicare UPIN
4695OtherCAREFIRST BCBS OF DC
0254450001Medicare NSC
0254450005OtherMEDICARE NSC
DG8302OtherRAILROAD MEDICARE
B93412Medicare UPIN
E61710Medicare UPIN
E95254Medicare UPIN
G86663Medicare UPIN